From the Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO (DEB, MP); and Washington University School of Medicine, St Louis, MO (AF, XL, LF, CW, PC-R).
J Addict Med. 2023;17(3):356-359. doi: 10.1097/ADM.0000000000001113. Epub 2022 Dec 13.
Pregnant and postpartum women and people (PPWP) who use opioids experience higher rates of morbidity, preterm labor, and stillbirth than those who do not. Although medication for opioid use disorder (MOUD) is the standard of treatment, utilization among PPWP has remained low because of MOUD stigma and misconceptions. The current report examined general and pregnancy-related MOUD attitudes, norms, and self-efficacy among PPWP seeking treatment.
Participants (n = 33) receiving MOUD at a Midwestern clinic reported beliefs about MOUD in general using the Attitudes toward Methadone Questionnaire (modified to include all MOUD) and during pregnancy/postpartum using an investigator-generated scale based on previous research. Participants responded using a 5-point scale from "strongly agree" to "strongly disagree" with higher scores indicating more positive attitudes. Analyses examined the bivariate association of attitudes with MOUD subjective norms and self-efficacy, also measured via investigator-generated scales.
Respondents reported positive attitudes toward MOUD use during pregnancy, with most agreeing it was safe. However, up-to-half of participants reported uncertainty regarding the appropriate dosage of MOUD and its impact on the fetus and/or neonate. Both general and pregnancy/postpartum-related MOUD attitudes were positively associated with subjective norms toward MOUD.
Pregnant and postpartum women and people reported high uncertainty about MOUD use despite currently using it, emphasizing the need for strategies that assess and mitigate MOUD-related stigma. Findings suggest that familial support and stigma impact attitudes toward MOUD and highlight the importance of accurate psychoeducation and social supports for patients and their families to improve the acceptance and utilization of MOUD among PPWP.
与不使用阿片类药物的孕妇和产后妇女及使用者(PPWP)相比,使用阿片类药物的孕妇和产后妇女及使用者经历更高的发病率、早产和死产率。尽管阿片类药物使用障碍(MOUD)治疗是标准治疗方法,但由于 MOUD 污名化和误解,PPWP 中的利用率仍然很低。本报告考察了接受 MOUD 治疗的 PPWP 对 MOUD 的一般和与妊娠相关的态度、规范和自我效能感。
在中西部一家诊所接受 MOUD 的参与者(n=33)使用修改后的美沙酮态度问卷(包含所有 MOUD)和基于先前研究的调查员生成的量表来报告对 MOUD 的一般和妊娠/产后态度。参与者使用 5 分制从“强烈同意”到“强烈不同意”进行回答,得分越高表示态度越积极。分析通过调查员生成的量表来检查态度与 MOUD 主观规范和自我效能之间的关联。
受访者报告了对 MOUD 在怀孕期间使用的积极态度,大多数人认为它是安全的。然而,近一半的参与者报告对 MOUD 的适当剂量及其对胎儿和/或新生儿的影响存在不确定性。一般和与妊娠/产后相关的 MOUD 态度均与 MOUD 的主观规范呈正相关。
尽管目前正在使用 MOUD,但孕妇和产后妇女及使用者对 MOUD 的使用仍存在高度不确定性,这强调了需要采取策略来评估和减轻与 MOUD 相关的污名。研究结果表明,家庭支持和污名会影响对 MOUD 的态度,并强调了为患者及其家属提供准确的心理教育和社会支持以提高接受和使用 MOUD 的重要性。